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  1. Laparoscopic adrenalectomy for nonmalignant disease : improved safety, morbidity, and cost-effectiveness.

    Article - En anglais

    Background 

    Laparoscopic adrenalectomy has rapidly gained widespread acceptance for treatment of benign adrenal neoplasms.

    A number of authors have compared various anatomic approaches to laparoscopic adrenalectomy, comparing length of inpatient stay, transfusion requirements, and perioperative complications.

    Separate studies have found inpatient stay reduced 40-60% with the use of laparoscopic adrenalectomy vs. an open procedure.

    Methods 

    There have been no studies designed specifically to examine and compare perioperative morbidity, length of stay, and patient charges in patients undergoing laparoscopic adrenalectomy.

    This report examines the Johns Hopkins Hospital experience with laparoscopic adrenalectomy in 22 patients, comparing length of stay, perioperative morbidity, and patient charges.

    These data are compared with those seen in 17 patients undergoing open adrenalectomy within our institution and 70 patients at all other nonfederal hospitals in the state of Maryland.

    Results 

    Outcomes after laparoscopic versus open adrenalectomy were compared.

    Resumption of diet (1.6 vs. 6.1 days), independent activity (1.6 vs. 7.9 days), inpatient length of stay (1.7 vs. 7.8 days), and total hospital patient charges ($8,698 vs. $12,610) were all significantly reduced in patients undergoing laparoscopic adrenalectomy at our institution.

    Similar findings were obtained when our data were compared against adrenalectomy performed at other hospitals within the state of Maryland. (...)

    Mots-clés Pascal : Surrénale pathologie, Traitement, Surrénalectomie, Voie abord, Laparoscopie, Indication, Sécurité, Morbidité, Analyse avantage coût, Evolution, Homme, Endocrinopathie, Chirurgie, Endoscopie, Economie santé

    Mots-clés Pascal anglais : Adrenal gland diseases, Treatment, Adrenalectomy, Surgical approach, Laparoscopy, Indication, Safety, Morbidity, Cost benefit analysis, Evolution, Human, Endocrinopathy, Surgery, Endoscopy, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0086389

    Code Inist : 002B25L. Création : 31/05/1999.